Archive for Service Learning

On Tuesday, we headed out of the beautiful Mont Joli and returned to Hope Haven, where we would be completing well child checks for the day. These checks consisted of not only gathering histories and performing head to toe assessments but also conducting developmental assessments. We were provided with Ages and Stages worksheets to guide us. These forms are typically provided to parents to fill out in the US at every well child check and assist with the provider’s assessment of the development in children in terms of communication, language, fine motor skills, and problem-solving.

There were numerous children there ranging from toddlers to older adolescents. One of the barriers that we faced this day was the lack of translators. Dr. Bussenius

asked us to focus on establishing trust through playful interactions and gathering objective data, so this was an opportunity to sharpen our head to toe assessments and to appreciate the value in simply enjoying the children we played.

In addition to completing the well child checks, we also found that many of these children had similar conditions as others within the community, such as scabies and parasites. We provided treatment and discussed what educational information we would want to provide families with children with these conditions with Dr. Bussenius. This gave us the chance to brainstorm and formulate plans from the role as the provider, with constructive feedback still being provided to us by our instructor. After completing these assessments, we stayed with the children to share in some of the toys, clothes, and treats we brought them from home. Seeing the smiles on their faces and the joy in their eyes simply from the attention we were giving them was truly heartwarming.

Over the next few days, we had many kinds of adventures in our new environment. Each of our clinic sites boasted unique patients, surroundings, and experiences. From the rural mountainside to the private inner-city clinic, we have treated numerous infants, children, and adults principally for infectious etiologies including scabies, giardia, nematodes, and helminths. One unique case that required additional facilitation from the Lillian Carter Center was a young man with pronounced elephantiasis secondary to lymphatic filariasis. He will be traveling the length of Haiti to see a specialist on the Southern Coast.

We have begun to understand the challenges of continuity of care within the Haitian healthcare system. For example, we have continued to monitor the care of the child transferred to the local hospital where is he being worked up for both HIV and TB. With the help of Eternal Hope in Haiti, he will continue to receive care, regardless of ability to pay.

Several of our FNP students had a crash course in the management of sexually transmitted infections and family planning; multiple young women were seen back to back with concerns about reproductive health. The team was able to provide them with extensive education regarding barrier protection and availability of multiple forms of birth control, including Depo-Provera and Nexplanon, at the nearby women’s health clinic.

We have valued our hours off as well. Traversing the Iron Market, where all the locals purchase their clothing, housewares, produce, and meat – sometimes while it is still alive! – was a view into Haitian culture that few foreigners can experience. Haggling at the souvenir markets gave us the opportunity to test our burgeoning Creole. The Citadel, a massive fortress built in the early 1800’s that overlooks the city, provided stunning views of the surrounding mountains and an insight into the complex history of the Haitian government.

Note: Wi-Fi in Northern Haiti has been spotty due to frequent storms and power outages. We are thrilled to belatedly share our adventures!

Our day began Monday morning in Atlanta. We caught an early flight to Miami. After a short layover and some Cuban sandwiches, we continued to our final destination: Cap-Haïtien, located on the Northern Coast of Haiti.

We deplaned on the tarmac and jostled our way into the crowded immigration line. Looking for our baggage… we found that it was directly in front of us in the single roomed international airport.

Breezing through the Customs Officers’ inspections, we went outside to meet our fearless leader Dr. Bussenius. We were whisked away in the tap-tap, the double-wide, open bed truck that would remain our sole source of transportation. Wilnick, our constant companion and Haitian guide, rode with us through the bustling city and up the steep hill to arrive at the lovely Mont Joli Hotel.

We made our way down the flowered path to our rooms. After dinner, we settled in for the night excited to begin our immersion clinical experience.

On our first clinic day, we awoke bright and early, excited to get to work. We piled into the truck and started off through town. We were surprised to find that Cap Haitien has a rush hour to rival Atlanta’s!

After we got past the traffic, we stopped at the women’s hospital and dropped off two of our students to work for the day. The rest continued, past the sugarcane fields, down a long county road line with grazing cattle and goats. Nearing the end of the drive, we were greeted by many people, young and old, walking down the dirt road towards the Eternal Hope Orphanage. We stopped briefly at the metal gate, which was let open by a guard. The truck drove through and the gate quickly closed again.

We hopped off the truck and began setting up the clinic in the shady courtyard of the orphanage. Several members of the team went outside of the gates and began triaging pediatric and adult patients.

Our busy outdoor clinic buzzed with activity as adult and pediatric patients were seen and treated at several different stations. A child was found to be so ill that he needed to be taken to a nearby hospital; two students accompanied him along with our trusted driver, Luken.

With supplies running low, we finished up clinic in the early evening. We saw 300 patients, more than had ever been seen on a single day. We headed back to the hotel, tired but happy at the end of a full day.

Days two and three were a whirlwind, as we embarked upon an adventure in the villages of Kwa Kok and Jaquet. Within two days we were able to see greater than 200 patients. Making diagnosis were drastically altered by the norms of the Haitian culture and prevalences of diseases in the community such as malaria, dehydration, typhoid, parasites, and nutritional deficiencies.

We were able to gather information from our patients with the help of our hardworking interpreters, who worked hard at gathering appropriate patient history. They also went above and beyond about educating us on Haitian culture.

The eve of both clinical days were spent sorting and labeling medications appropriate for our patient population. In comparison to the US when treating our patients we were often unable to use first line treatment, we were required to be creative with our medication choices.

Despite the overwhelming amount of patients seen we were able to work well as a team and meet the needs of our patients.

My name is Jordan Waites. I am a Junior in the traditional BSN program. I am an active member of Emory Global Health Nursing Association, Global Medical Missions Alliance, Emory Student Nurses Association, and BUNDLE scholar. I have always enjoyed aiding underserved populations through various volunteer opportunities. I have served in rural areas of New Mexico, Alaska, and Peru. Additionally, I have volunteered at Mommy & Me Family Literacy Program with Friends of Refugees in Clarkston, Georgia. After observing the needs of these populations, my long-term goal is to provide compassionate patient care in the mission field. I am grateful for the opportunities provided by Nell Hodgson Woodruff School of Nursing because volunteer work is a true passion of mine. When I found out about an opportunity to volunteer at a weekend camp for families with high-functioning children on the autism spectrum, I felt led to offer my time. I personally felt passionately about this opportunity because I have an adult brother who struggles with Asperger’s Syndrome. I have witnessed society’s negative attitude towards my brother. He is a happy, unsuspecting young man who wants to be accepted. I realize the importance of unconditional love, compassion, and the need for positive collaboration between families and counselors.

As a volunteer “Family Pal,” my task during the weekend camp was to assist families with activities. This allowed me to work very closely with children on the spectrum as well as their family members. As I was exposed to various families, I noticed that although many of the children were on the high-functioning end of the spectrum, they were all unique. Each of them had different struggles and concerns. Many could verbally communicate, whereas some only used 2-3 word sentences. Some could implement problem-solving, however, others experienced anxiety during activity. Throughout the weekend, I heard the quote, “When you meet one child with autism, you only meet ONE child with autism,” and I could not agree more with the statement. The struggles of one child could be another’s strength and vice versa. I learned through my camp experience that children and adults on the autism spectrum require personalized care. I believe that this knowledge is vital to understand as children and adults continue to be diagnosed on the autism spectrum.

I could not be happier that I took advantage of the opportunity that was provided to me by the School of Nursing. I am sure that many of the families who attended are very pleased that they were given the opportunity as well. On the final day of camp, a mother shared with me that her daughter recently had trouble with peers at school. The child would pull her hair out due to frustration and anxiety and children at school would question and mock her. The mother explained to me that camp was an opportunity for her daughter to be around other children who may struggle with the same difficulties. She expressed that the weekend camp was a safe place for her child to triumph over her struggles. In a similar way, volunteering at a weekend camp was a wonderful opportunity for me to step back from the stress of exams and deadlines in nursing school. It was a unique experience that enabled me to make a positive impact in the lives of others. Individuals with disabilities often are stigmatized, encountering not only physical barriers in daily

Individuals with disabilities often are stigmatized, encountering not only physical barriers in daily life but also emotional barriers. Loved ones cannot always protect them from subtle forms of discrimination and prejudice. School-age children with disabilities often have negative school experiences related to their disability. I understand the support families need and the importance of empathetic care. As a nurse, I look forward to providing support and helping families create a positive environment, focusing on their child’s aspirations instead of their limitations.

Whenever I get the question “Why did you choose nursing school?”, I almost always respond with my usual, “You know, it just kind of happened.” That question takes me back a bit and makes me think about why I chose nursing and how I got here. Occasionally I even think back to an information session where we were presented with the wide varieties of undergraduate studies at Emory. I remember that I turned to my friend, and laughed at the idea of becoming a nurse. Although it often feels like nursing school was just something that just happened to me, I sure am glad that it happened. I am glad that I tagged along with my friend to a pre-nursing club “Meet the Juniors” event that got me thinking about nursing school. I am glad that this profession, that is rooted in caring, found me.On my very first day of classes in nursing school I hoped and prayed that I had made the right decision, and I have found over the course of my four semesters here that I am indeed in the right place. I did not know much about public or global health or the role of nurses in those settings until I got to nursing school. I did know, even before nursing school, that I would like to spend my career providing care in any way I could to anyone who needs it. As a scholar in the Building Nursing’s Diverse Leadership at Emory (BUNDLE) program I have learned about public health nursing, the need for cultural diversity and awareness in nursing and nursing care, and being a nurse leader and a force for change. Between my classes and my BUNDLE experience I found that I wanted to be a public or global health nurse. My alternative winter break trip to Montego Bay, Jamaica (which I was on the fence about going to) really confirmed that for me.Upon arrival in Montego Bay, we were on the road and ready to take on our first project a few hours after arriving. I had never been happier and filled with a greater sense of fulfillment while immensely exhausted as I was on this trip. We were gone from early in the morning to late at night setting up clinics in churches, teaching reproductive health, doing yoga with hearing impaired students and so much more. One of many profound moments for me was when a man who had visited our church clinic came back with a bunch of plantains for a student who had taken his blood pressure to show thanks for the care he received. Our clinic on that day simply offered blood pressure and glucose checks, BMI calculation, some health education, and a few incentives such as anti-fungal cream and reading glasses. These are things that do not seem like much to us in the United States, but a farmer in rural Jamaica valued these simple things so much that he was willing to give us his produce as a token of appreciation.This experience solidified my goal to become a public/global health nurse. It reminded me that there are people around the world, and even in the United States, who do not have the resources that we take for granted. Whenever I think back to the experience, I want to continue to strive toward the goal of sharing the skills and knowledge that I have been fortunate enough to gain through my nursing school experience and training. I want to use these skills to empower others around the world to take charge of their health. I hope to continue to learn and push myself as an individual and a nurse from my experiences with the diverse groups of people I encounter.

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Elizabeth Balogun is a BSN 2017 student and a BUNDLE scholar. She is from Lawrenceville, Georgia and hopes to become a public/global health nurse providing care for low resource and underserved populations around the world.

In my first semester of nursing school, my volunteer hours were spent at the Friends of Refugees program called Mommy and Me in Clarkston, Georgia. In this Family Literacy program, mothers are taught ESL while their children are exposed to the English language as well through language nutrition. This intervention is based upon evidence and multiple studies, and these studies have shown that the more exposure to words a child receives in his or her first few years of life, the higher their chances of achieving literacy in his or her younger school-age years and the better chances they have of attending university and obtaining jobs later in life. So, in short, language nutrition is of utmost importance, especially for this population of refugee children who are being raised in homes in which English may not be used often.

After my first semester volunteering with this program, I had spent sufficient time in the various classrooms interacting with the children and I thought that I had a grip on what public health meant for this community. It was plain and simple. Learning the language was the most important factor in the process of these refugees becoming integrated into American society, so I thought.

This semester, my second at the nursing school, was when I began my full population health clinical. Coincidentally, I was placed at the same site as where I volunteered last semester, the Friends of Refugees Mommy and Me program. Since I had spent some time volunteering at Mommy and Me last semester, I thought I knew what to expect for my clinical portion of population health at Mommy and Me. As before, I thought I would arrive at the Clarkston refugee school, be introduced to a new class’s teacher, and then spend the morning speaking and playing with the refugee children of that class until their mothers came to retrieve them at noon.

During my second clinical day at Mommy and Me, though, all of my expectations were exceeded. This time, I felt more empowered. During our pre-clinical meeting in the morning, we discussed our roles as student nurses in this clinical—which involves responsibilities such as noticing refugee children who may have health conditions that aren’t being treated or observing community-wide health issues or gaps in knowledge. This time around at Mommy and Me, I was given a task and a tangible goal, to improve the overall health outcome of the Clarkston refuge community, whether through individual or community actions.

My morning began as I expected. I joined an older toddler classroom, where I aided with snack time, played with the children during playtime, and gave the children as much language nutrition as I could. However, after lunch, my instructor took my group to a refugee resettlement agency, New American Pathways. All we were told was that we would be helping the agency with a program they were planning. I went into this meeting with few expectations.

When I walked out of the New American Pathways building after our meeting, I felt empowered. I felt that my one year of nursing education could already be used to make a difference. The opportunity that we were asked to help with was a Women’s Sexual Health Education class for Middle Eastern and Eastern African Refugee women involved in the North American Pathways organization. My clinical group was given the responsibilities of finding reliable academic sources, creating an appropriate lesson, and fully executing the class when the day came. The education of these women now fell in our hands. And we could feel the immense responsibility that we now all had. We have just begun research on topics in women’s health, and my excitement is growing with each step in the process.

In my time at Mommy and Me, I feel that this experience will equally benefit me as it does the refugees we interact with. I will have my assumptions challenged, and I will come out a more aware and conscientious person. Since my own parents came to the United States as immigrants just two decades ago, I am gaining a better glimpse through interactions with the families at Mommy and Me, just what my parents went through on their journey toward making the United States their new home.

***

Jessica Nooriel is a junior BSN student. She chose nursing for its holistic views on both preventative and curative medicine. Her passion for exploring the various health practices and beliefs of different communities and cultures drove her to join the Emory International Nursing Students Association (EISNA). She is tri-lingual in English, Farsi, and Hebrew, and hopes to use these skills for interpretative services within health care.

Yesterday we drove from Caguas (near San Juan) to the south side of the island. We are in Ponce to work at a nursing home for our last service day, but first we had a delightfully warm welcome from the Ponce civic representatives, including the head of tourism. We explored the quaint and colorful town square and some of the city’s main sights, including a tree believed to be more than 500 years old.

At Parque de la Ceiba

The director of tourism passes out “Ponce Passports” for our tour of the city. Credit: David Zhao

Ponce town square. Credit: David Zhao

Today we served at Asociacion Benefica de Ponce, home to about 35 senior citizens. We helped with bathing and dressing, medication administration, and wound care. We also attended a lecture on palliative care by one of our leaders, Dr. Weihua Zhang. Members of the nursing home staff as well as nursing assistant students sat in on the lecture, which included an insightful comparison of end-of-life care in the continental U.S. versus Puerto Rico. As one might expect, many of of the emotions and rituals are the same, but we did learn that some people on the island practice Santeria, a Caribbean religion with its own spiritual traditions.

One of the most profound parts of our visit to the Asociacion was connecting with the clients one-on-one. One of our leaders, Gladys Jusino, took out her guitar and sang traditional Puerto Rican songs with the clients.

Gladys Jusino plays guitar for a nursing home client. Credit: David Zhao

A bed-ridden woman listens to music at the Asociacion. Credit: David Zhao

A client and nurse of the Asociacion clap along to music. Credit: David Zhao

We were reminded that a smile and a gentle squeeze of the hand are universal gestures that transcend language barriers.

Credit: David Zhao

Credit: David Zhao

Credit: David Zhao

We ended the day with a bird’s eye view of Ponce and sleepy car ride back to our headquarters near San Juan.

Credit: David Zhao

Our service learning trip has come to an end, and tomorrow we fly back to Atlanta. I think I can speak for everyone in our group when I say that we were humbled and honored to have been a part of this trip to Puerto Rico. We met incredibly gracious and intelligent people, we learned about the island’s vibrant culture and history, and we aimed to care for, in however small a way, some of its most vulnerable citizens. Thank you to our brilliant and fearless leaders, Gladys Jusino and Weihua Zhang, and their family members that accompanied us.

Wepa, a Puerto Rican word that implies joy and good cheer, was brought up a lot during this trip. Gracias, Puerto Rico, for welcoming us with open arms. We will be back! ¡Wepa!

Today we spent the morning at the Colegio de Profesionales de la Enfermera, an organization for nurses in PR similar to the American Nursing Association, learning about nursing and the state of health care in Puerto Rico. In order to practice as an RN, nurses here must have a college degree in nursing as well as membership in this professional association. The director of the Colegio, Juan Carlos, told us that a recent Puerto Rican law decreased the number of sick and vacation days for all workers, and increased their probation time before becoming permanent employees. Juan Carlos also told us that in recent decades, Puerto Rico has seen a “brain drain” of its workforce to the continental U.S., including the departure of nurses. The Colegio is hard at work advocating for better pay and working conditions for its members.

Posing with Florence Nightingale at Colegio de Profesionales de la Enfermera. Credit: David Zhao

Juan Carlos ended his talk with a quote in Spanish from Florence Nightingale that referred to nursing as “un llamado superior,” a higher calling.

After another yummy Mofongo meal for lunch, we traveled to a local hospital where a very special organization – PITIRRE – is headquartered.

Mmmmofongo. Credit: David Zhao

I’ll let one of our team members, Tara Noorani, take it from here:

“My admiration for nurses was born from an exposure to street medicine. Their ability to address the entirety of the person was something displayed during each client interaction.

Wednesday (March 8th) began at PITIRRE de Iniciativa Comunitaria, an addiction treatment program offering healthcare, education and prevention services to homeless and HIV-positive clients. The pitirre is a bird found in Puerto Rico weighing nearly 1.5 ounces and personifying somewhat of a powerful underdog. El pitirre serves as a symbol of hope and resilience in the face of adversity. The staff at PITIRRE emphasized the bond between ourselves and our fellow human – the tie between providers and clients. They encouraged us to understand our intersection as brothers and sisters and the power in our collaboration with one another.

With this lesson in mind, we began our night by making sandwiches with members of Operacion Compasion de Iniciativa Comunitaria, a mobile clinic project rooted in Rio Piedras, Puerto Rico. We assembled hygiene kits, brewed gallons of coffee, and collected juice boxes, medications and wound care supplies into their mobile clinic truck. From 10pm to 3am, we combed the streets, in search of possible clients.

Led by two of the most humble leaders of Operacion Compasion, we treated a total of 38 clients and performed wound care on 6 of these people. We offered blood pressure screenings, glucose checks, coffee, juice and sandwiches. We witnessed the isolation a person endures in the street and how the label “homeless” overlooks their humanity. Inevitably this manifests into a marginalized community drowning in stereotypes and misconceptions.

When I reflect on this experience, I’m reminded of the importance of being present with those who suffer. The nature of homelessness obscures the client’s voice and visibility. By meeting these people where they are, we are choosing to resist the poverty and injustice of their circumstances. As student nurses, we have an obligation to uphold the individuality and autonomy of each client and oppose the forces impeding their access to care.

As Emory students, it is a privilege to serve the people of Puerto Rico, a pleasure to have been enriched by their culture and an honor to advocate for their health care needs.”

Today began the real reason we came to beautiful Puerto Rico: to be in service to the community. We started the morning with a yummy breakfast of eggs and sausage that the wonderful staff at the local Salvation Army (where we’re staying) made for us. We then got to work on our health fair (or, in Spanish, La Feria de Salud).

Local residents from public housing came to the Salvation Army chapel where we had several tables set up: blood pressure checks, glucose checks, self-breast exam information, and smoking cessation. We split up into teams of two or three and about 30 people came. We (along with our Puerto Rican-native professor and our nurse practitioner professor) counseled people on lowering blood pressure and managing diabetes. Some realized they needed to go back to the doctor to adjust their medications, and others got advice on lifestyle modifications. We felt strongly that we made a difference in these people’s lives, and they expressed their gratitude. It was a lovely morning of health education and outreach!

Checking blood sugar

Teaching a breast self-exam

During lunchtime, we were lucky enough to have a talk with Dr. Dana Thomas, a career epidemiology field officer with the CDC. She spoke with us about how Zika has affected Puerto Rico, and we were shocked to hear that an estimated 400,000 people have been infected with the virus. One important takeaway was that 75% of people infected with Zika are asymptomatic, so it can spread among people without their knowledge.

Universal Sim Man

In the afternoon, we visited National University College, a private university system on the island that has a robust nursing program. We received a warm welcome complete with gift bags and hats, and were able to see how nursing students here learn — turns out, it’s quite similar to us! They have simulation rooms and clinicals. We even recognized some of the sim mannequins as the same ones we have at Emory.

We then had a discussion with some of the nursing students about life as a student and nurse in PR. They were extremely knowledgeable and friendly. We learned that it’s more difficult here than in the continental U.S. to get a job as a new nurse. In fact, many of the students were hoping to come to the states to work once they graduated. We also realized that nursing is a universal language — we were all in the profession for the same reasons — to be an advocate for our patients and to promote and heal. Some of their students were fresh out of high school and some were older and had families, just like our programs. No matter our backgrounds, we all could commiserate about how tough nursing school is. 🙂

Swapping nursing student stories

Big thank you to the amazing staff and students at National University College in Caguas, Puerto Rico!